Ethical Considerations in Shamanic Healing
By Susan Mokelke, J.D.

"Rebirth," Painting by Beth Lenco
Introduction
In this article I hope to surface some of the issues involved in ethical shamanic healing, as well as to provide some basic guidelines. As with most decisions involving questions of ethical behavior, this commentary is not intended as rigid policy, but rather as a flexible standard to be considered thoughtfully and compassionately in each particular case. It is hoped that this might be a starting place for those beginning a shamanic practice, as well as an opportunity for experienced practitioners to deepen their own understanding. [1]—Susan Mokelke
Shamanic practitioners are part of an ancient lineage of spiritual healers. Since shamanic healing is a form of spiritual healing, the question of ethics is of particular importance. When Michael Harner began offering training in Core Shamanism in the seventies, shamanic healing was relatively unknown. Thanks to the success of his pioneering work, today thousands of people worldwide practice shamanic healing, and there is currently considerable interest in guidelines for the principled use of this powerful method.
For those who practice shamanic healing with clients face-to-face, the ethical responsibilities regarding appropriate physical contact are similar to those of a therapist. Additionally, as is well-known by traditional shamans, shamanism is a spiritual practice that works beyond space and time, which is what makes healing at a distance possible. Thus, physical contact with a client is not necessary for a powerful and effective healing session, [2] which often is more comfortable for clients and ensures boundaries are fully respected. Confidentiality, too, must be strictly observed. Any information received from the client or during the shamanic session must be kept private.
Because shamanic healing deals with the spiritual aspect of illness, the parameters of ethical practice often seem unduly broad, vague, and imprecise. What is permissible at the level of spiritual healing? What about “distance” healings offered by individuals, groups, and drumming circles—where the person, place, or situation being healed may be miles or a continent away? Those who have been involved in shamanic healing or divination for any length of time, either as practitioners or as recipients, know that it is powerful. Miracles of healing can and do occur. Difficult questions are answered in surprising and useful ways; problems that seem nearly impossible to resolve suddenly shift and elegant solutions appear. This power deserves our respect and serious consideration about where and how it is used.
Permission
In shamanic healing, to use the power of the helping spirits consciously and compassionately so that the work we do will in fact be healing, there is one essential ethical requirement: permission. Permission means the express, informed consent of the client for a specific individual or group to perform shamanic healing or divination. This means that the potential client understands generally what shamanic healing is and that we work with fully compassionate spirits of the Upper and Lower Worlds. [3] It also includes the client’s specific verbal or written consent to disclose any information about the client, should a request for healing be sent to other shamanic practitioners.
Healing without permission is unethical and strays into the realm of sorcery. It is unethical because each person has the right and the responsibility to decide what to do in matters of their own soul. Each person has the right to choose their path without interference or undue influence. It doesn’t matter how clear it is to you that the person needs help or how sure you are that “they would grant permission.” Unless you have been asked, or you have asked them and been granted permission (informed consent), you must not do the work. It is well worth taking the time to journey to your compassionate helping spirits to ask why this is so, to know deeply for yourself why the consent of the recipient is essential for shamanic work to be truly healing.
Those who are drawn to healing typically have a deep desire to help others. It can be very tempting when you see someone suffering, and know that this person could be helped, to quickly ask the helping spirits for a healing without the person ever knowing anything about it.
But none of us is wise enough to know what another’s soul wants or needs. I’ve heard practitioners say that if the helping spirits say it is all right to heal someone, then it is OK even if you don’t have the person’s permission. This is not ethical—first because you should not ask the helping spirits until you have permission; and, secondly, the helping spirits may be all-knowing, but we humans are all too fallible, subject to errors of interpretation as well as to hearing what we want to hear.
Informed consent means that in ordinary reality the person who will receive the work knows that you will be offering spiritual healing and that you will be working with helping spirits on their behalf. If the healing is to be face-to-face, and some physical contact may be made, it is important ask the client if it is all right to touch them if necessary during the healing session.

Express Permission
Express permission means that the person has asked you for healing or you have asked them and they have said, “Yes.” If the person is alive and conscious, this means a direct ordinary reality “yes.” It does not mean that you asked them in a dream or in a journey or telepathically, or asked your power animal or teacher, or that you had your power animal ask their power animal, and so on.
If a person is in a coma, permission should be obtained from the immediate family in order to do shamanic work. Even then, the person’s soul should be contacted in the journey to ask what work, if any, he or she wishes to be done.
In the case of deceased persons, for psychopomp work or other shamanic healing involving souls, permission is still required. Souls are souls, living or dead. When journeying to help a deceased person, their soul should be asked what, if anything, it wants done.
For shamanic healing work performed on behalf of children under about the age of twelve, you should have a parent’s (preferably both parents’) permission. On a case-by-case basis, depending upon the maturity of the child, you may also need permission from the child. Where healing is done with the child present, the child should have shamanic healing explained to them in a manner appropriate to their age and one or both parents should be present during the session. For most teenagers under 18, just as for adults, express permission of the teen as well as a parent is required for shamanic healing.
Within a healing session, clients will sometimes ask questions or make requests about another person. Remember, you may only work with the client; you do not have permission to work with the client’s spouse, relatives, or anyone else associated with the client. I.e., you may not ask for information about another person or offer healing to another person.
Most of the time, clients will come to you with a specific request for healing for an injury, illness, emotional problem, or for divination help for a particular difficulty in their lives. For example, a client asks you to “heal my broken heart.” In this case, you have express permission to work on their “broken heart” and whatever you see that is related to that issue. You do not necessarily have permission to go beyond that. However, it is not unusual to ask the helping spirits for healing for one thing, and have another seemingly unrelated issue surface. Some shamanic practitioners feel that if they have a client’s permission for healing for one thing, that permission extends to a general permission for healing. Others confine themselves to healing only what was requested. Though the issue of permission is somewhat flexible and each shamanic healer has to decide, in consultation with the spirits, what to do in an actual circumstance, it is best to err on the side of caution. Fortunately, in most cases you can simply ask the client if they want you to address the additional issue.
Focus on Shamanism
Since clients come to you for shamanic healing, shamanic healing is what they should receive. Until you become a master in more than one healing discipline, it has been my experience that trying to combine two or more modalities simply weakens the power of the healing. Shamanic healing has its own unique power—in the hands of an experienced practitioner it is sufficient to get the job done.
As to ordinary reality interactions during a healing session, even though you really want to help, resist the impulse to offer advice, therapy, medical diagnoses, legal suggestions, relationship counseling, conflict resolution, etc. If you feel these things might help the client, suggest that they may want to obtain additional help from a trained professional in these fields; or, offer this kind of advice outside of the shamanic session.
Working With Animals
I am sometimes asked about working with animals. I apply the same guidelines I use with people to this work. Since an animal cannot speak, one must journey to the soul of the animal to ask for permission.

Distance Work
Lately there has been a proliferation of requests for distance shamanic healing, often communicated via email, phone apps, or in drumming circles. This has vastly increased the opportunity for people to receive shamanic healing and has led to some impressive miracles of healing. It has also made the question of permission even more critical—and harder to know for certain that it has been obtained.
There are several kinds of “non-local” healing requests one can receive: for prayers, sending light, holding a specific intention—world peace, for example —and many others. While these requests have their own ethical considerations, I am not addressing them in this article, which is limited to the ethical practice of shamanic healing and divination.
When a request for shamanic healing is made, whether by email, phone, or in a group or drumming circle, permission is still essential. The same rules that apply for work face-to-face with an individual client extend to distance healing. The person requesting healing must have given his or her informed, express, consent for the healing—and where a group is involved—must understand that information about the request will be released to the group for the healing. If you receive a request to a group you are part of for healing, you must not share that request with others outside that group. If you wish to do so, you must gain specific permission for this additional sharing.
It is particularly important when doing work in drumming circles or through group emails to do only the work that was requested. So, if a person asks for divination help, only divination work confined to the question that was asked should be done. If a specific healing is requested, follow the parameters set for the healing.
For example, if the request is for a “successful knee-replacement surgery, with minimal pain and fast recovery,” there is no need for you to also ask for “release of fear,” a competent surgeon, and so on. Respect the distant client’s right to define what they need.
Lastly, especially when working via email, if you receive information that needs to be communicated to the client, communicate it privately—to the person, or through the person who made the request—but certainly not as a reply to the group. Use bcc with emails. Even using email, maintaining the client’s privacy is an important consideration, and is not guaranteed. It is also recommended that the person making the request collect the healing responses on behalf of the person seeking healing, acting as a point person so the client is not overwhelmed with information.

Shamanic Help For Natural and Human Caused Disasters
Note: One of the most helpful things you can do in these cases is to act in ordinary reality, with input on how to help from the compassionate spirits. [4]
The issue of permission in offering shamanic help can be particularly confusing in these cases, especially if you are dealing with another country and culture, whose ways and people are unfamiliar. Permission is still essential in these cases, but permission from whom or what? If you want to help, it is necessary to make an initial shamanic journey to the place in the Middle World where the incident occurred. Ask the spirits of the place and any souls of animals or deceased people you contact if they want help—always ask before doing any work. If you contact a living person, then you cannot do work without verbal permission; it is not sufficient to ask the soul. If you receive permission to help, then you can engage in shamanic healing within the scope of the permission you receive, with the assistance of your helping spirits.
Occasionally, I have seen requests to do shamanic work to influence a specific outcome in the larger world—elect a certain candidate to public office, “open the heart” of a person in power, even stop a war, etc. There is no permission for shamanic work in these cases, which are beyond the scope of ethical shamanic practice and, however well-intentioned, border on sorcery.
Even working with something like the weather has ethical considerations. If you work to “end a drought” or to bring rain, for example, this work can also affect surrounding areas in unintended ways. The Earth is a whole, a living organism—everything we do has consequences, everything we do affects everything else, for good or ill.
Healing is a profound and many-layered undertaking. Often the right thing to do is ambiguous and difficult to define—even more so because there is so much need, we care so much, and really want to help.
If there is any doubt about whether it is appropriate to offer shamanic healing, the simple answer is to ask the intended recipient, whether it be a person, animal, or place. If you do not receive clear permission, do not proceed unless and until you do. If you receive permission, then work closely with your helping spirits, stay within the parameters of the request, and do the work.
Shamanic Healing Scenarios
Here are a few scenarios of shamanic healing ethical problems, from my own practice and from clients and colleagues. Each raises issues of permission for you to consider from the standpoint of the ethical responsibilities of a shamanic practitioner.
- A client asks for a shamanic divination to determine when a seriously ill relative might die.
- An exercise class instructor decides to offer a healing meditation at the end of a class. She instructs the participants to pair up. Then she offers a kind of guided visualization. She asks the pairs to send healing first to each other, then to each other's family members, then to the world. A shamanic healer is in the class.
- A client claims she was sexually harassed and asks for shamanic help dealing with it. After the session, the practitioner telephones someone who knows the man in question to find out if it could be true, and what she should advise her client to do about it. (Consider: Would it make any difference if the practitioner had the client's permission to ask the other person?)
- In a journey, a shamanic practitioner meets the soul of a dead relative. The deceased relative asks the practitioner to perform a shamanic healing for a living person.
- A shamanic practitioner, after consulting with her helping spirits, journeys to the scene of a natural disaster outside of her own country and immediately begins to do psychopomp work. (Consider: What if another shamanic practitioner received permission at the site or from the helping spirits to do healing work?)
- A client requests help in resolving a conflict she has with a neighbour. Without intending it, during the session the shamanic healer receives personal information about the neighbor that could be important for the client to know. He tells the client the information.
- A legal conservator (appointed by a judge to manage the financial affairs and/or daily life of another due to physical or mental limitations, or old age) asks a shamanic healer to work on behalf of a patient under a conservatorship. What permission issues are involved? What if there are known living relatives of the patient?
- A client requests shamanic help in dealing with a dispute he has with a business colleague. The shamanic practitioner tells him he should consider filing a lawsuit against the colleague.
- A person asks for psychopomp work to be done for a close relative. The deceased person's other relatives are strongly opposed to it.
- A client's house has been robbed. A shamanic practitioner is asked for divination work to identify and/or locate the burglar.
- A shamanic practitioner who is very sensitive does healing work for others in dreams. Private information is often received. Would it make a difference if it was unintended? If the practitioner knows the people personally? If the practitioner's helping spirits are involved?
Footnotes
- Learn more about the ethical practice of shamanism in these FSS workshops: in person, Shamanism in Practice: Ethical, Effective, and Inspired Shamanic Healing or online Inspired Shamanic Practice: Essentials of Effective & Principled Shamanic Healing.
- In addition to many years of experience with advanced students in FSS Three Year programs, during the pandemic we had many opportunities to verify the effectiveness of formal shamanic healing sessions via video conference. Most of my clients reported that the video sessions were equally as powerful as in person.
- In providing clarity to potential clients, in addition to a conversation, before an appointment is made, I send them a link to Michael Harner’s interview: Shamanic Healing: We Are Not Alone.
- FSS Polestar: Shamanism in natural or human-caused disasters.
Acknowledgements
First published: ©Shamanism Annual, December 2008, Issue 21.
Revised: ©Shamanism Annual, December 2023, Issue 36.
Updated: January 2025
Thanks to my teachers—Michael Harner, Sandra Harner, and Alicia Gates—for their wisdom and guidance in the ethical practice of shamanism.
Susan Mokelke, J.D., is the President of the Foundation and directs the FSS Faculty. She teaches the FSS Three Year Program, as well as maintaining a shamanic healing practice.
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